By Ralph Sahakian, D.M.D., P.C.
March 21, 2019
Category: Uncategorized
Tags: nutrition  
HeresHowtoManageSchoolSnacksandYourChildsDentalHealth

Besides daily hygiene and regular dental visits, the best thing you can do for your kids' dental health is to see that they're eating a nutritious diet. And not just at mealtime—healthy snacking also promotes healthy teeth and gums.

Healthy snack foods are quite similar to their counterparts at mealtime: fresh fruits and vegetables, whole grains and low-fat dairy. At the same time, you should avoid providing processed snacks high in sugar, salt, unhealthy fats and calories.

Managing snack choices at home is usually a simple matter of discipline and follow-through. When they're at school, however, it's a bit trickier as they may encounter snacks sold on school grounds or offered by fellow students that don't meet your definition of a healthy food. Public schools follow nutrition guidelines from the U.S. Department of Agriculture (USDA) on snacks sold on school grounds, but many dentists don't believe the standard goes far enough to protect dental health.

So, what can you do to combat these less healthy snack choices your kids may encounter at school? For one thing, you can work with your child's school officials to exceed the USDA guidelines or turn off snack vending machines right before lunch to lessen kids' temptation to skip lunch.

You can also interact with your children to better manage their schooltime snacking. But rather than issue blanket commands about what they should snack on at school, help them instead understand the difference between nutritional foods and less nutritional ones, and why it's important to choose healthy snacks for their life and health.

Finally, don't send them to school empty-handed—pack along nutritious snacks so that they won't seek out vending machines or their classmates to satisfy the munchies. You can supercharge your efforts with a little creativity (like a dash of cinnamon in a bag of unbuttered popcorn) that make your snacks fun and more enticing than other school ground options.

It's not always easy to keep your kids from unhealthy snack choices. But with a little commitment, interaction and ingenuity, you can help steer them toward snacks that are tooth-friendly.

If you would like more information on boosting your child's dental health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Snacking at School: How to Protect Your Child's Teeth and Promote Good Nutrition.”

By Ralph Sahakian, D.M.D., P.C.
March 11, 2019
Category: Dental Procedures
Tags: root canal  
ASecondRootCanalTreatmentMayHelpSaveanEndangeredTooth

When decay spreads to the tooth’s inner pulp, a root canal treatment may be necessary to save it. It’s a common procedure: after removing all tissue from the pulp, the pulp chamber and root canals are filled with a special filling. The tooth is then sealed and a crown installed to protect the tooth from re-infection and/or fracture, possibly extending the tooth’s life for many years.

Sometimes, however, the tooth doesn’t respond and heal as expected: the number, size and shape of the patient’s root canals may have complicated the procedure; there may have been a delay before installing the final crown or restoration or the restoration didn’t seal the tooth as it should have, both occurrences giving rise to re-infection. It’s also possible for a second, separate occurrence of decay or injury to the tooth or crown to undo the effects of successful treatment.

It may be necessary in these cases to conduct a second root canal treatment, one that may be more complicated or challenging than the first one. For one thing, if the tooth has been covered by a crown or other restorative materials, these will most likely need to be removed beforehand. In cases where the root canal network and anatomy are challenging, it may require the expertise of an endodontist, a dental specialist in root canal treatments. Using advanced techniques with microscopic equipment, an endodontist can locate and fill unusually narrow or blocked root canals.

Because of these and other possible complications, a root canal retreatment may be more costly than a first-time procedure. Additionally, if you have dental insurance, your particular benefit package may or may not cover the full cost or impose limitations on repeated procedures within a certain length of time. The alternative to retreatment, though, is the removal of the tooth and replacement with a dental implant, bridge or partial denture with their own set of costs and considerations.

The complications and costs of a repeated procedure, though, may be well worth it, if it results in a longer life for the tooth. Preserving your natural tooth is in most cases the most desired outcome for maintaining a healthy mouth.

If you would like more information on root canal treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Root Canal Treatment.”

By Ralph Sahakian, D.M.D., P.C.
March 01, 2019
Category: Oral Health
AnyTimeAnyPlaceCamNewtonsGuidetoFlossing

When is the best time to floss your teeth: Morning? Bedtime? How about: whenever and wherever the moment feels right?

For Cam Newton, award-winning NFL quarterback for the Carolina Panthers, the answer is clearly the latter. During the third quarter of the 2016 season-opener between his team and the Denver Broncos, TV cameras focused on Newton as he sat on the bench. The 2015 MVP was clearly seen stretching a string of dental floss between his index fingers and taking care of some dental hygiene business… and thereby creating a minor storm on the internet.

Inappropriate? We don't think so. As dentists, we're always happy when someone comes along to remind people how important it is to floss. And when that person has a million-dollar smile like Cam Newton's — so much the better.

Of course, there has been a lot of discussion lately about flossing. News outlets have gleefully reported that there's a lack of hard evidence at present to show that flossing is effective. But we would like to point out that, as the saying goes, “Absence of evidence is not evidence of absence.” There are a number of reasons why health care organizations like the American Dental Association (ADA) still firmly recommend daily flossing. Here are a few:

  • It's well established that when plaque is allowed to build up on teeth, tooth decay and gum disease are bound to follow.
  • A tooth brush does a good job of cleaning most tooth surfaces, but it can't reach into spaces between teeth.
  • Cleaning between teeth (interdental cleaning) has been shown to remove plaque and food debris from these hard-to-reach spaces.
  • Dental floss isn't the only method for interdental cleaning… but it is recognized by dentists as the best way, and is an excellent method for doing this at home — or anywhere else!

Whether you use dental floss or another type of interdental cleaner is up to you. But the ADA stands by its recommendations for maintaining good oral health: Brush twice a day for two minutes with fluoride toothpaste; visit your dentist regularly for professional cleanings and checkups; and clean between teeth once a day with an interdental cleaner like floss. It doesn't matter if you do it in your own home, or on the sidelines of an NFL game… as long as you do it!

If you would like more information about flossing and oral hygiene, contact us or schedule an appointment for a consultation.

By Ralph Sahakian, D.M.D., P.C.
February 19, 2019
Category: Oral Health
Tags: gum disease   oral health  
TakeCareofYourGumsTakeCareofYourHeart

At this time of year, hearts are everywhere you look, so it's fitting that February is American Heart Month, a time to focus on cardiovascular health. Cardiovascular disease, which includes heart disease and stroke, is the number one cause of death around the world. But did you know that there's a link between the health of your heart and the health of your mouth?

People with advanced gum disease have a higher risk of having a heart attack, stroke or other cardiovascular event, but what is the connection? For one, oral bacteria found in gum disease can enter the bloodstream, where it has been found in artery-clogging plaque. In addition, untreated gum disease has been determined to worsen high blood pressure, a major contributor to heart attack, stroke and heart failure. One study reported that when gum disease was treated, high blood pressure fell by up to 13 points. But perhaps the most significant common denominator between gum disease and heart disease is inflammation, according to many researchers.

Gum disease is the most common inflammatory disease, affecting nearly 50% of US adults over 30, and 70% of those aged 65 and older, according to the U.S. Centers for Disease Control. The body's inflammation response is a key weapon in fighting infection. However, when there is chronic low-level inflammation such as occurs with untreated periodontal (gum) disease, many adverse health effects can result. In one Harvard University study, chronic inflammation was found to triple the risk of heart attack and double the risk of stroke.

The relationship between gum disease and heart disease is still not completely understood, but there's no denying that a connection exists between the two, so it's worth doing what you can to take care of both your gums and your cardiovascular health. Here are some tips:

  • Eat a heart-healthy—and gum-healthy—diet. A diet low in refined carbohydrates, high in fiber, vitamins C and D, antioxidants and Omega-3s has been shown to lower inflammation, benefitting your gums and your heart.
  • Quit smoking. Using tobacco in any form is a risk factor for developing both gum disease and heart disease.
  • Take care of your oral health. Gum disease can often be prevented—and reversed if caught early—simply with good oral hygiene, so be diligent about brushing your teeth twice a day and flossing once a day.
  • Come in for regular cleanings and checkups. Regular cleanings can help keep your gums healthy, and an examination can determine if you have gum disease. Be sure to tell us about any medical conditions or medications.

As you think about what you can do to take care of your heart health and overall health, don't forget your gums. If you have questions about how to improve your oral health, call us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Good Oral Health Leads to Better Health Overall” and “Carbohydrates Linked to Gum Disease.”

By Ralph Sahakian, D.M.D., P.C.
February 09, 2019
Category: Dental Procedures
Tags: porcelain veneers  
ANewVeneerwithMinimalorNoToothAlteration

Dental veneers, thin layers of porcelain bonded to chipped, stained or slightly crooked teeth, are an effective and affordable way to transform your smile. Their color, translucence and shape blend so well with the rest of your teeth that it's often difficult to tell them apart.

But traditional veneers have one drawback: although they're less than a millimeter in width, they can still appear bulky on unprepared teeth. To help them look more natural, we often have to remove some of the enamel layer from the tooth surface. Enamel doesn't grow back, so this alteration is permanent and the prepared teeth will require a restoration from then on.

But you may be able to avoid this—or at least keep the alteration to a minimum—with no-prep or minimal-prep veneers, two new exciting choices in cosmetic dentistry. About the width of a contact lens, we can bond these much thinner veneers to teeth with virtually no preparation at all or, in the case of a minimal-prep veneer, needing only an abrasive tool to reshape and remove only a tiny bit of the enamel.

These ultra thin veneers are best for teeth with healthy enamel, and can be placed in as few as two appointments. And besides being less invasive, the procedure is reversible—we can remove them and you can return to your original look without any follow-up restoration. One caveat, though: because of the strong bonding process used, it's not always easy to remove them.

Although their thinness makes it possible to avoid or minimize alterations, there are some dental situations like oversized teeth that may still require extensive tooth preparation. With some poor bites (malocclusions) orthodontic treatment to straighten the teeth may also be needed first.

All in all, though, no-prep or minimal-prep veneers could help you avoid the permanent tooth alteration that usually accompanies their thicker cousins. What's more, you'll have the beautiful, transformed smile that veneers can achieve.

If you would like more information on minimal or no-prep veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “No-Prep Porcelain Veneers.”





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Ralph Sahakian, D.M.D., P.C.

14 Lake Avenue Worcester, MA 01604